Transcript
Ohio’s PCMH Education Pilot
Colette R. Willins, M.D.President
Ohio Academy of Family Physicians
Successfully advocated for passage of medical home bill
Lots of chapters have done
So what’s the big deal?
Thanks for AAFP recognition
Stepping up to the plateNo $$No staffNo structureNo home
Filling the Void of Leadership
Lesson Learned from the OAFP experience:
“Successful passage of legislation is sometimes just the beginning of the
advocacy journey.”
Take Home Message
H.B. 198 – Ohio’s Medical Home Bill
Created PCMH Education Advisory Group – to implement and administer pilot
Bill sponsor Rep. Peggy Lehner receiving OAFP Friend of Family
Medicine Award
H.B. 198 Objectives
Facilitate more rapid adoption of PCMH model by primary care physicians
Create practice sites where medical students, residents and nurses can experience PCMH model
Revise medical student, resident and nursing curricula to incorporate PCMH principles.
H.B. 198 Objectives
Attract and retain PCPs in Ohio by producing a more satisfying practice environment
Enhance quality of care delivered to citizens of Ohio
Enhance patient’s health care experience in PC office and community
H.B. 198 Objectives
Bend the health care cost curveMake health care more affordable and
accessibleCreate an organization that would
facilitate bringing available funding to Ohio for PCMH implementation
Evidence Supporting PCMH Value
NC Medicaid:40% decrease in asthma hospitalizations15% improvement in diabetes measures16% decrease in ED visits
Boeing Seattle Pilot – 20% cost reduction
Evidence Supporting PCMH Value
TransforMED analysis of 36 PCMH practices:58% increase in physician satisfaction66% increase in staff satisfaction
Evidence Supporting PCMH Value
Group Health of Puget Sound PCMH Model:36.3% drop in hospital stays32.2% drop in ED utilization9.6% reduction in total cost10.5% drop in inpatient specialty care18.9% drop in ancillary costs15% drop in outpatient specialty costs
Charges of PCMH Education Advisory Group
Select 44 primary care practices with at least 4 being APN-led for participation
Practices must have affiliated teaching agreements with area’s medical and nursing schools
Focus on 4 regions of state (Dayton, Toledo, Akron/Canton and Athens)
Charges of PCMH Education Advisory Group
Seek funding for project (no funding in bill)
Provide PCMH model training to participating practices
Work with medical and nursing schools to develop curricula in PCMH model of care
Advisory Group Membership
Voting Members: Medical school reps (4) OAFP (2) Ohio Chapter ACP (1) Ohio Chapter AAP (1) OOA (1) Ohio Council of Deans – Nursing (1) ONA (1) OAAPN (1) ODI (1)
Advisory Group Membership
Non-voting membersState Medical Board (1)Board of Nursing (1)Chancellor, Board of Regents (1)Medicaid (1)ODH (1)
Leadership
Ted Wymyslo, M.D., OAFP – Past ChairPat Ecklar, M.D., ACP, Ohio – Current
ChairRichard Snow, D.O., OOA – Co-Vice
Chair Jeri Milstead, R.N., PhD, ONA – Co-Vice
Chair
OAFP’s Role
Launch/coordinate work of EAG and its task forces
Coordinate monthly meetings Keep the group on track, moving
forward in the same direction
OAFP’s Role
Fiscal/administrative management agentWorked with leaders in each of 4 regions to
promote understanding of projectCoordinated work of consultants to recruit
practices to apply for pilot participationWe are the glue holding everything
together
Advisory Group Organizational Structure
Three Task Forces and Chairs:Funding/Reimbursement Reform – Dr. SnowPractice Selection/Metrics – Dr. BertkaCurriculum – Dr. Costa
Funding/Reimbursement Reform Group Initially pulled together application materials
for state grant funding - $300,000 Worked with sustainability consultant to:
Develop case for support Write sustainability plan Identify potential funding opportunities Prepare boilerplate application materials for grant
funding Submit 2 applications for grants
Practice Selection/Metrics Group
Determined pilot measurement metrics Developed a process for selecting
practices for pilot participation64 practices applied; 44 were selected - 37 physician-led
practices; 7 APN-led practices
Practice Selection/Metrics Group
Worked with TransforMED to evaluate practice applicants:Utilized established, evidence-based
assessment toolsCollected regional input on applicantsVerified required affiliated teaching
agreementsVerified board certification of participants
Curriculum Group
Developed integrated PCMH medical and nursing curriculum – with emphasis on: Importance of personal clinician Patient-centeredness Team approach Integrated, coordinated care Continuous quality improvement Importance of information systems Timely access
Still looking for fundingContinued communication with
practices to keep them engagedOAFP remains administrative/fiscal
agent through December 31, 2011ODH assumes responsibility January 1,
2012
Next steps
Everyone is talking about primary careODH Director selected for job because
of his advocacy for PCMHAdministration supports PCMHEAG is positioned to led the effortCollaboration on this project with nurses
has eased some historic tensions
Opportunities
Challenges
Talk about value of primary care and PCMH is cheap
Practice transformation is expensive for PCP practices operating on a shoestring
For politicians, PCMH is akin to motherhood and apple pie – they like the sound of
Show me the $$$
Project Web site:
http://ohioafp.org/OhioPCMHProject/
Organizational Structure
Project Contacts
Expectations & Responsibilities
Resources & Tools
Meeting Minutes, etc.
Final Thoughts
In a void of leadership, OAFP stepped in to fill the void
OAFP moved the effort forward when no one else stepped up to lead
ODH is now positioned to take over project administration and is actively engaged in fundraising
Final Thought
“Successful passage of legislation is sometimes just the beginning of the
advocacy journey.”
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